New Member- Jesse (low BG)

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JesseTheCat

JesseTheCat

Member Since 2022
Hello, I'm new to the forum with Jesse, but I was a member 10+ years ago with another diabetic cat who I never was able to regulate.

Jesse was diagnosed back in October, but I did not do home testing for multiple reasons. I trusted my vet, and I decided to be more relaxed with Jesse, who is a very neurotic cat. He was a stray, and is afraid of everything, but he is super sweet. His ear tips are damaged from frostbite, so testing would be difficult. But that being said, I learned my lesson because he was Hypo last Friday and now we are trying to figure out his dosing.

We were at 4 units of Vetsulin twice a day for months. We went in last Friday for a normal fructosamine test, that came back low (189), so the vet dropped his dose to 3 units, and his blood work was sent to the lab. The vet left a message the next day that his blood glucose was real low and to skip the next 2 shots, and then give him 3 units.

On Tuesday (after a long holiday weekend), I found out from the vet that his BG was 39 on Friday! I immediately bought a glucose meter and checked his BG, which was 68 +12 (skipped shot), and 164 +24 (skipped shot). Last night, +36 he was 264, and the vet dropped him to 2 units. This morning he was 103, +12. So we are skipping the next 3 shots, and the vet wants me to check his BG every 6 hours. She is thinking we will drop him to 1 unit, but she wants to give him a rest and see what BG is at that point.

Jesse showed no obvious signs of hypo. The only subtle signs were that he was hiding, which could have been normal because we have company, and he peed inappropriately. Today he is out more, playing and preening. At 2 pm, I will check him again. We are lucky.

Looking for guidance and support. I never had low or even normal sugar readings with my old cat. I am hoping that Jesse is on his way to healing. He has had a hard life.

Thank you!
 
Welcome Liz and Jessie, can you please add to your signature the date Jessie was diagnosed .
I will give you the link to set up your spreadsheet, if you have trouble just ask and a member will set it up for you
I'll tag Melissa
@FrostD for you to read your post
 
Does he have any history of ketones that you're aware of?

Even 2U is far, far too much.

I would start over at 0.5U and give that about 5 days. It's possible he may run higher and need some increases, but he'll get back on track. Prioritize your preshot tests (are those fasting for 2 hrs prior by the way?). Be sure to fast for 2 hrs, take the preshot reading, then feed, wait 30 minutes then give the shot. With Vetsulin it's important they have some food on board since it typically hits pretty hard.
 
Thank you!

He has no ketones that I'm aware of, but I'll get some strips to make sure, and I'll follow your protocol for testing. That is also what the vet recommended - no food before the tests.

He just tested at 235 at +19. But the vet wanted me to hold off on insulin until tomorrow PM to make sure he's not bouncing from low sugar and to start over fresh. She also wanted BG readings tomorrow morning and afternoon.
 
JesseTheCat said:
Thank you!

He has no ketones that I'm aware of, but I'll get some strips to make sure, and I'll follow your protocol for testing. That is also what the vet recommended - no food before the tests.

He just tested at 235 at +19. But the vet wanted me to hold off on insulin until tomorrow PM to make sure he's not bouncing from low sugar and to start over fresh. She also wanted BG readings tomorrow morning and afternoon.
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I don't know what you mean by 235 @+19?
Wouldn't that 235 be @+7 like you entered it on your SS
@FrostD

@JesseTheCat
 
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Thanks! I wasn't sure if that was the correct way of writing it.

It's now 39 hours after his last insulin shot, and his BG is 310. My vet still does not want me to give him a shot. She wants me to check again at 2:00 pm, withholding food 2 hours before, and call with results.
I'm concerned he will go too high, but the vet wants to start over this evening with a new lowered dose, and since his BG is dropping so much, she wants his sugar high enough to handle the insulin if he drops so much again.
 
Just want to be sure you have your hypo kit set up in case you need to bring Jessie's BG numbers up
Med and High Carb food and some honey



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart.

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
 
Thank you! That’s great to know. Vet dropped his dose to 1 unit, and he was 134 at +4. I’m keeping my eye on him tonight.
 
Keep a close eye as you have been - I'm guessing his preshots will come down (if he doesn't bounce) and that 1U will likely be too high.
 
Back again! After a couple of days on 1 unit, Jesse has a morning pre shot BG of 179. I’m not sure if I should keep at 1 unit or go to a .5 like suggested before, or skip the shot?

I left food out in case he dropped too low, so he may have eaten before test and he’s not hungry now. I wish I had more BG numbers overnight to see how low he is going. He woke up up playing on the bed, purring and cuddling.

Any advice appreciated!
 
JesseTheCat said:
Back again! After a couple of days on 1 unit, Jesse has a morning pre shot BG of 179. I’m not sure if I should keep at 1 unit or go to a .5 like suggested before, or skip the shot?

I left food out in case he dropped too low, so he may have eaten before test and he’s not hungry now. I wish I had more BG numbers overnight to see how low he is going. He woke up up playing on the bed, purring and cuddling.

Any advice appreciated!
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I can tag Melissa for you to look at your SS and in the remarks it says 0.75 units @+14?
Should she note that in the cell Melissa

@FrostD
 
Yes, thank you! I waited 2 hours and rechecked. His BG was then at 213, so I decided on .75. I'm going to test in an hour to see how he is doing. He is relaxed now and giving himself a bath. So happy to see him act like a normal kitty.
 
Jesse is down to 80. I just spoke to the vet and she would like to stop all insulin for 1 month and then do a fructosamine test. She is concerned he is dropping too low and would prefer he is in the 200-300 range than hypo.
 
JesseTheCat said:
Jesse is down to 80. I just spoke to the vet and she would like to stop all insulin for 1 month and then do a fructosamine test. She is concerned he is dropping too low and would prefer he is in the 200-300 range than hypo.
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I will tag Melissa for you
@FrostD
, but I don't think it's a good idea to stop insulin for a month, plus she wants to wait a month to do a fructosamuine test?
The range she wants is crazy, if you are home testing enough , especially at night , you can set an alarm to get up you are in control of raising Jessie's BG if needed
You can always post and ask for help
What an adorable face Jessie has

Melissa should be on later tonight
I would still continue to check Jessie's BG if I were you
@FrostD
 
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I am nervous about taking him off insulin completely and not doing tests to see if his BG is staying in check. I do trust my vet, but I am so confused and want to do the right thing for Jesse. The vet doesn't like home testing because she thinks it makes cats too stressed, but with the advice on the forum, Jesse is becoming quite calm during testing - not that he likes it. Without home testing, the vet wouldn't have these numbers at all. I would have given him 3 units when he was at 68 BG. She wanted him to come to the office for a BG test a week after the dose change.

I do have some apprehensions because my old cat's vet had me wait a month to see if he was really diabetic. He ended up with DKA and never really recovered.
 
JesseTheCat said:
I am nervous about taking him off insulin completely and not doing tests to see if his BG is staying in check. I do trust my vet, but I am so confused and want to do the right thing for Jesse. The vet doesn't like home testing because she thinks it makes cats too stressed, but with the advice on the forum, Jesse is becoming quite calm during testing - not that he likes it. Without home testing, the vet wouldn't have these numbers at all. I would have given him 3 units when he was at 68 BG. She wanted him to come to the office for a BG test a week after the dose change.

I do have some apprehensions because my old cat's vet had me wait a month to see if he was really diabetic. He ended up with DKA and never really recovered.
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I see Melissa is on
@FrostD
H Melissa can you also read post #18
Thank you
 
To put it bluntly I do not trust your vet when it comes to the nuances of FD, she has made several bad decisions now that have almost killed him, and also the home testing is stressful baloney. True we do not want them below 90 while on Vetsulin, so I would go with the 0.5U I originally recommended.

It is a bad idea to stop insulin completely at the moment - due to the DKA risk you mentioned.

For now, give 0.5U.if he's above 200. You can stall without feeding and wait for him to come up, or if you can skip if he's below. Keep getting tests around +4/+5. If 0.5U is too much then we would try 0.25U, then 0.1U...then if that's still too much then you know it's ok to try discontinuing insulin. It may be Vetsulin is too harsh for him and he needs a different one.
 
JesseTheCat said:
I agree. Thank you! This is as stressful as the diagnosis. He is at 93 now, so his numbers are going up.
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Hi Liz I was just reading about Jessie again and that his ears are damaged from frostbite and that he has had a hard life . I almost cried reading that.
Thank you for taking him in. He's lucky to have you.
He has such a precious face and those big eyes .
Please listen to Melissa and not your vet.
Some members are here for 30 years
If it wasn't for them Tyler would not be in remission today knock on wood
@JesseTheCat
 
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He's such a good cat and a true love. I think he was living under our porch for a while before I even knew he was there. I have a feeling he was a barn cat from a surrounding farm and got kicked out by a dominant cat. He was so scared of everything!
It took all his nerve to come out and meow that he needed help.
 
JesseTheCat said:
He's such a good cat and a true love. I think he was living under our porch for a while before I even knew he was there. I have a feeling he was a barn cat from a surrounding farm and got kicked out by a dominant cat. He was so scared of everything!
It took all his nerve to come out and meow that he needed help.
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Aww I could cry right now ♥
I'm glad you gave him 0.5 units tonight
 
Ok 0.25U too much. let's see how he does with the skip.

Up to you now, at this point I would recommend a drop dose before discontinuing insulin (I know yesterday I said 0.1U but with how far he likely dropped, drop dose is better).

To get a drop dose, you push the plunger down as hard as you can, then insert into vial. Release the pressure on plunger, result is one drop of insulin (not visible in syringe). When you give the shot, same thing - hold down as hard as you can, ideally for about 10 seconds to give it time to absorb.
 
Thanks! Afternoon reading of 161. I'll see how he is later tonight. Do you think he's going into remission or that the insulin is too strong for him? Do cats get hyper-sensitive to Vetsulin after hypo?
 
Could be either! Once he settles down we'll see. His numbers aren't too bad so I'm leaning more towards he's close to remission. We just want to give insulin support as long as safely possible to allow his pancreas to fully heal.
 
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